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PRE 2010 DOCSSUBJECT PER O. City of Fridley 7 ®- AT THE TOP OF THE TWINS BUILDING PERMIT RECE `v -.---- COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. r � PROTECTIVE 1 � = CITY HALL FRIDLEY 53432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/22/99 10B ADDRESS 4700 2 Street NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 14,15 5 I Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Chuck Ostic 4700 2 Street NE 571-4950 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Norling Exteriors Inc 341 79 Way NE, Fridley, MAT 55432 784-8936 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098700 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION (j REPAIR 0 MOVE O REMOVE 8 DESCRIBE WORK Reside House 9 CHANGEOFUSEFROM TO STIPULATIONS a Call for building wrap inspection before covering. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $7,200 @ $3.60 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $137.25 Fi C $7.20 PLAN CHECK FEE TOTA Fqt Gtis SC $5 V53.05 . SIGNATURE OF CONTRACTORORA TwORQED AGE T IDATEI WHE PR AL HIS IS Y BL G IhSP sPEAPA ® GATE S-GNATURE OF OWNERIIF OWNER BUILOERI IDATEI NEW [ ] Effective 1/l/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 'a"57 -Ale- Fr, iclle, M., X- ya4 Legal Description: Owner Name & Address: v e k 0 Tel. # _ '11 - q f. ,p Contractor: tuav--11 PI!2) (? }�-�� r �,,, � t MN LICENSE # f ro 9,9 Address: 3 q I W &_ rK n Vic( 3 Tel. # Y 3�_ LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach td this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Construction Type: h -,c 5-1 de 6.o5 P Estimated Cost: $ % , (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: V - D J, iq` APPLICANT: /' 06�'? n ( e 1)8 ' I r & ( Tel. # -S_/,_1, -1 2 -70 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ]